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House of Representatives
Session of 2013 - 2014 Regular Session


Posted: December 13, 2012 10:41 AM
From: Representative Bernie O'Neill
To: All House members
Subject: Prosthetic Reimbursement (Previous HB 783)
I plan to re-introduce legislation that will require reimbursement for prosthetic devices. Specifically, this legislation will require that all private health insurers provide coverage for the fitting, repair or replacement of a prosthetic device and/or component.

Initial research has identified at least eight different companies in this Commonwealth that have imposed restrictions on prosthetic coverage. These restrictions range from annual caps and lifetime caps to 50% co-pays to one prosthesis per lifetime. Imagine a child who has suffered from a catastrophic illness or injury which resulted in limb loss. It is unconscionable to think that this child could possibly have coverage under a company who limits prosthetics to one per lifetime. It is imperative to ensure that this child, their family, never have to endure any additional trauma.

At the present time there are six states (Colorado, Maine, New Hampshire, Rhode Island, Massachusetts and California) that have passed similar legislation. There is a tremendous effort sweeping across the country and with the support of the Amputee Coalition of America, there are eleven other states that are working to introduce and advance legislation.

I feel we have a responsibility to ensure that individuals living with the loss or absence of a limb are able to lead productive lives. Accessibility will not only improve the physical and psychological functioning of persons with amputations, injuries and congenital disabilities, but will also reduce the incidence and costs associated with secondary conditions, such as ; obesity, cardiovascular disease and additional amputations.

If you have any questions on this legislation, please contact Connie McClure in my Harrisburg office at 705-7170 or by e-mailing cmcclure@pahousegop.com.

Thank you for your consideration and support of this very important piece of legislation.

Introduced as HB320